| NPI | 1730355603 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MICHAEL J BOIKE Business Manager 763-270-0054 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: MN 15207) |
| Enumeration Date | 2008-05-01 |
| Last Update Date | 2024-02-26 |